The present invention relates to medical equipment and, more specifically, to devices for gripping soft tissues during surgical intervention. The proposed device may be employed for fixing the walls of an organ or tissues with a view to performing certain manipulations therewith, for example, for gripping the walls of a hollow organ by the surface layers thereof, setting them apart and maintaining them apart, or for gripping and turning the edges of dissected tissues, or for moving the edges of dissected tissues in a prescribed direction. The proposed device may be employed, inter alia, in stitching surgical apparatus, viz, apparatus for suturing hollow organs, e.g., in applying intestinal anastomoses. The proposed device may be employed in other surgical instruments as well, for example, in clamps for gripping intestinal walls or the wall of the bladder, in wound expanders, which are required, according to the conditions of surgical intervention, to stay outside of the wound cavity and to grip the walls of the wound being expanded on one side only, viz, on the side of the surface layers.
There is known a device for gripping soft tissues during surgical intervention which is employed in an instrument for stitching intestines. This known device is disposed on the jaws of two clamps of the instrument for stitching intestines which comprises a suturing means composed of a staple magazine, a staple pusher and a die for clinching the staples. The known device for gripping soft tissues comprises two movable plates with cooperating paired fixing needles, a cover for fastening the plates to the jaws, and a slide for displacing the plates with the fixing needles. The plates with the fixing needles are mounted in recesses formed in each jaw of the instrument so as to adjoin each other by way of the lateral surfaces thereof. The fixing needles of both plates are spaced at equal intervals on the longitudinal faces of the plates and are so curved that the tips of the needles of one plate point in a direction opposite to that in which the needle tips of the other plate are oriented. With the plates in the initial position, the paired needles stay apart. The needles are set in the recesses formed in the clamp jaws.
The plates with the needles are provided with inclined slots of equal length, the inclined slots of one of the plates changing into longitudinal slots whose length is equal to the distance between the tips of the paired curved needles in the initial position. The length of the plate with the inclined and longitudinal slots is equal to the length of the recess formed in the jaw, and this plate is adapted to move only laterally with respect to the jaw. The length of the plate with the inclined slots is shorter than that of the recess, this latter plate being adapted to move both laterally and lengthwise with respect to the jaw. The slide is provided with projections entering the plate slots.
The slide and, accordingly its projections occupy two extreme positions relative to the plates with the needles; in one of these positions, the initial position, the tips of the paired curved needles are set apart and recessed in the clamp jaw, whereas in the other position they are closed and protrude from the jaw.
The known device for gripping soft tissues in the instrument for stitching intestines operates as follows.
After the tissues have been gripped between the jaws of one of the clamps, the slide is displaced, with the projections of the slide acting on the inclined slots of the plates with the needles so that both the plates simultaneously extend from the clamp jaw and the tips of the needles transfix the surface layers of the tissues. As the slide moves further, the shorter plate displaces lengthwise, with the slide projections displacing in the longitudinal slots of the other plate which at this instant is immobilized relative to the jaw. The paired needles of the plates have their pointed tips brought together, gripping the tissues in nodes.
While manipulating the clamps in order to juxtapose the organ walls being sutured as well as while manipulating the magazine, the pusher and the die in order to suture the juxtaposed walls, the device for gripping soft tissues fixes the walls of the organs relative to the clamp jaws. Upon completion of the suturing operation, the slide is moved back, with the paired needles of the cooperating plates moving apart and retracting into the clamp jaw, releasing the clamped walls of the organs.
The known device for gripping soft tissues has a disadvantage which consists in that the fixing needles of both cooperating plates are curved, the needle tips of one plate being oriented toward the needle tips of the other plate and set apart in the initial position of the plates. Hence it is sometimes impossible to disengage the device from the tissues or organ being fixed without damage thereto. After gripping tissues in the course of surgery and after the paired curved needles of the plates are moved apart to release the tissues being fixed, the tissues are drawn by the needles into the recesses of the jaws and gripped by the needles which point in the direction of withdrawal of the device from the operation wound. Thus, for the above-stated reasons, having sutured organs with the aid of the known instrument for stitching intestines comprising the above-described device for gripping soft tissues, it is sometimes impossible to avoid traumatizing the intestinal walls while withdrawing the instrument, for the needles of the clamp plates fail to release the tissues after fixing.
The particular design of the known device for gripping soft tissues with movable plates bearing fixing needles adapted to extend from the clamp jaws adds to the complexity of the device and requires an increased cross-sectional area of the clamp jaws, which constitutes a drawback when the limited size of the operation wound is considered. However, the unfavorable shape and arrangement of the paired needles of the plates necessitate a design whereby the needles are recessed in the clamp jaws in their initial position, though a device with permanently protruding needles would be much simpler in design, for otherwise the protruding sharpened needle tips are liable to traumatize the hands of the surgeon or operator in the course of cleaning and preparing the device for operation as well as the organs being fixed and the surrounding tissues. Besides, the device having protruding needles is difficult to handle, for while it is being brought to the tissues or organs to be fixed and established in a desired position, the needles cling to the tissues.
The shape of the sharp-tip fixing needles and their arrangement in the known device do not guarantee that hollow organs, e.g., intestines, the stomach or the bladder, are gripped only by way of the surface layers of the walls, without penetration into the cavity of the organ, in a wide range of organ wall thicknesses.
It is an object of the present invention to provide a device for gripping soft tissues during surgical intervention which would ensure secure fixing of tissues and releasing of the fixed tissues.
Another object of the present invention is to provide a device for gripping soft tissues during surgical intervention which would ensure absolute safety of the fixed and surrounding tissues and organs, as well as of the hands of the surgeon or operator cleaning and preparing the device for operation.
A further object of the invention is to provide a device for gripping soft tissues during surgical intervention which would ensure that the walls of organs are gripped only by way of the surface layers thereof, without penetration into the organ cavity, in a wide range of organ wall thicknesses.
Yet another object of the invention is to provide a device for gripping soft tissues during surgical intervention which would be simple in design and convenient to clean.